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Yu J, Si H, Liu Q, Li Y, Zhou W, Wang C. Does Social Support Moderate the Relationship Between Frailty and Functional Ability Trajectory Among Community-Dwelling Older Adults? J Gerontol A Biol Sci Med Sci 2024; 79:glae145. [PMID: 38813979 DOI: 10.1093/gerona/glae145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Functional ability is the important prerequisite to live independently and achieve aging in place, which depends on the complex interaction of intrinsic and extrinsic factors. Identifying the trends and influencing factors of functional ability would contribute to the accurate assessment and intervention of geriatric health. This study aimed to disentangle the moderating effect of 3 types of social support, namely objective support, subjective support, and support utilization, on the relationship between frailty and functional ability trajectories. METHODS This was a secondary analysis using data from a prospective 3-wave study with a sample of 777 Chinese community-dwelling older adults. Social support was assessed using the Social Support Rating scale. Frailty was assessed using the FRAIL scale. Functional ability was measured by the Lawton Instrumental Activities of Daily Living scale. Latent growth curve models were implemented to test their relationships. RESULTS Objective support but not subjective support or support utilization moderated on the relationship between frailty and functional ability slope. Functional ability decline over time was buffered by objective support among robust individuals but exacerbated among (pre)frail individuals. CONCLUSIONS The moderating effect of social support on the relationship between frailty and functional ability trajectory varies by support types, which reminded that social support may be a promising intervention target to maintain functional independence for frail individuals, opening up a new perspective on social support in the field of disability prevention. Effective interventions should particularly address objective support in conjunction with empowering the frail older population to optimize the trajectory of functional ability.
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Affiliation(s)
- Jiaqi Yu
- School of Nursing, Peking University, Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, Beijing, China
| | - Qinqin Liu
- School of Nursing, Peking University, Beijing, China
| | - Yanyan Li
- School of Nursing, Peking University, Beijing, China
| | - Wendie Zhou
- School of Nursing, Peking University, Beijing, China
| | - Cuili Wang
- School of Nursing, Peking University, Beijing, China
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Burrell LV, Rostad HM, Wentzel-Larsen T, Raknes Sogstad MK. Allocation of Adult Day Care Services to Different User Groups: A Register-Based Cross-Sectional Study. Health Serv Insights 2024; 17:11786329241231003. [PMID: 38332842 PMCID: PMC10851712 DOI: 10.1177/11786329241231003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
The international policy of active ageing emphasises activities and social relations for long-term care recipients, for example through adult day care. Knowledge about who are allocated such services is, however, sparse. We aimed to investigate characteristics that contribute to determine allocation of adult day care for care recipients with and without dementia. This study selected all 250 687 individuals who received long-term care services on 31 December 2019 from the Norwegian Register for Primary Health Care. We added municipal level data from the Municipality-State-Reporting register and a national survey. Multilevel analyses comparing allocation of adult day care services to other services found that municipal clustering was around 20%. Care recipients who lived alone had higher odds of receiving adult day care, while the odds of receiving adult day care decreased as age increased. Disability level and gender were also significantly associated with allocation of adult day care, but in different directions for different user groups. As the unrestricted revenues of municipalities increased, the odds of allocating adult day care to people without dementia decreased. Other municipality characteristics did not significantly impact the allocation of adult day care. In conclusion, individual characteristics were more influential in allocation of adult day care than municipality characteristics, and the results uncovered clear differences between care recipients with and without dementia.
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Affiliation(s)
- Lisa Victoria Burrell
- Centre for Care Research, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Hanne Marie Rostad
- Centre for Care Research, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Tore Wentzel-Larsen
- Centre for Care Research, Norwegian University of Science and Technology, Gjøvik, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
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Prieur Chaintré A, Couturier Y, Nguyen TT, Levasseur M. Influence of Hearing Loss on Social Participation in Older Adults: Results From a Scoping Review. Res Aging 2024; 46:72-90. [PMID: 37157996 PMCID: PMC10666503 DOI: 10.1177/01640275231174561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study aimed to provide a comprehensive understanding of the influence of hearing loss on social participation in older adults and including its facilitators and barriers. Following the rigorous methodological framework of scoping studies, nine multidisciplinary databases were searched with 44 keywords. Published mainly in the last decade, 41 studies using primarily a quantitative cross-sectional design were selected. Older adults with hearing loss have been found to have difficulty maintaining relationships and social activities. While social support and engaged-coping strategies were major facilitators of social participation, barriers included greater hearing loss, communication difficulties, comorbidities and reduced mental health. To better promote the social participation of older adults, early detection of hearing loss, holistic assessment, and interprofessional collaboration must be considered. Future research is necessary to better address the stigma related to hearing loss in older adults and challenges of early detection, and to propose innovative solutions to develop interprofessional collaboration.
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Affiliation(s)
- Agathe Prieur Chaintré
- Faculty of Letters and Social Sciences, Université de Sherbrooke, Quebec, Canada
- Research Center on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Quebec, Canada
| | - Yves Couturier
- Faculty of Letters and Social Sciences, Université de Sherbrooke, Quebec, Canada
| | - T.H. Trang Nguyen
- Faculty of Letters and Social Sciences, Université de Sherbrooke, Quebec, Canada
- Research Center on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Quebec, Canada
| | - Mélanie Levasseur
- Research Center on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Quebec, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada
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Ali T, Elliott MR, Antonucci TC, Needham BL, Zelner J, de Leon CFM. Network Types and Functional Health in Old Age: It is Not Just the Size of the Network That Matters. J Aging Health 2023:8982643231209351. [PMID: 37863092 PMCID: PMC11031614 DOI: 10.1177/08982643231209351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
OBJECTIVES Findings on the effect of network size and support on functional health are mixed. We examine whether network types, that simultaneously incorporate multiple network characteristics, are associated with functional health in late life. METHODS Data are from the National Social Life, Health, and Aging Project (N = 3005). We estimated the longitudinal effect of membership in five multidimensional network types on disability in six activities of daily living using negative binomial regression, and on mobility (assessed using a timed walk test) using a generalized linear mixed model. RESULTS Compared to those in the large without strain network, older adults in the small, restricted, high contact network had fewer disabilities but worse mobility, while those in the large network with strain also had worse mobility. DISCUSSION Care plans focusing on function and mobility should consider multiple aspects of older adults' social networks including network size, diversity, and relationship strain.
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Affiliation(s)
- Talha Ali
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Michael R. Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Toni C. Antonucci
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Belinda L. Needham
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jon Zelner
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Zhao D, Chai S, Gao T, Li J, Zhou C. Physical Mobility, Social Isolation and Cognitive Function: Are There Really Gender Differences? Am J Geriatr Psychiatry 2023; 31:726-736. [PMID: 37147164 DOI: 10.1016/j.jagp.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/19/2023] [Accepted: 04/05/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE This study aimed to examine the mediating role of social isolation between physical mobility and cognitive function, and whether there are gender differences in the above mediating effects among Chinese older adults. METHODS This is a prospective and cohort study. We obtained data from the 2011 (Time 1, T1), 2015 (Time 2, T2) and 2018 (Time 3, T3) waves of China Health and Retirement Longitudinal Study, including 3,395 participants aged 60 years or above. Cognition was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing, which was widely used in previous research. We used a cross-lagged model to test the hypothesis that social isolation mediated the association between physical mobility and cognitive function among Chinese older adults. RESULTS The total effects of T1 physical mobility limitations on T3 cognitive function (β = -0.055, bootstrap p < 0.001) were significantly negative. Social isolation played a mediating role among both males and females (male: β = -0.008, bootstrap p = 0.012; female: β = -0.006, bootstrap p = 0.023), demonstrating that the mediating effect of social isolation between physical mobility and cognitive function was not gender specific. CONCLUSION This study confirmed that social isolation mediated the association between physical mobility and cognitive function among both Chinese male and female older adults. These findings indicate that reversing social isolation can be a priority intervention target for cognitive decline prevention and promote successful ageing, particularly among older adults with impaired physical mobility.
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Affiliation(s)
- Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Shujun Chai
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China; NHC Key Lab of Health Economics and Policy Research (Shandong University) (CZ), Jinan, China; Institute of Health and Elderly Care, Shandong University (CZ), Jinan, China.
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Bhatia R, Hirsch C, Arnold AM, Newman AB, Mukamal KJ. Social networks, social support, and life expectancy in older adults: the Cardiovascular Health Study. Arch Gerontol Geriatr 2023; 111:104981. [PMID: 36965200 PMCID: PMC11026051 DOI: 10.1016/j.archger.2023.104981] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Social support and social networks have long been postulated to impact health outcomes but their impact on life expectancy and disability in older adults remains poorly quantified. METHODS As part of the Cardiovascular Health Study, we followed 5,749 adults aged 65 years and older from 4 US field centers for 25 years. We assessed the Lubben social network score [range 0-50] and a social support score [range 0-24] derived from the Interpersonal Support Evaluation List (ISEL-12) in two consecutive years starting at study recruitment. We used remaining years of life (YOL) from study enrollment to death to approximate life expectancy. We defined years of active life (YAL) as the number of study years in which participants lived without any difficulties in activities of daily living. We used compression of disability to reflect the proportion of life lived able (YAL/YOL). We used linear regression to adjust for socio-demographics and comorbidity. RESULTS The mean (standard deviation [SD]) scores were 32.3 ± 6.8 points for social network score and 8.3 ± 2.4 points for social support score. For every 1-SD increase in social network score, adjusted participant life expectancy was 0.40 years higher (95% CI 0.22-0.58; p<0.0001) and disability-free life expectancy 0.35 years higher (95% CI 0.18-0.53; p<0.0001). The association with life expectancy was modified by participant age (p<0.001), but it remained significant even among participants aged ≥75 years (3 months per SD; 95% CI 0.1-6 months, p = 0.04). Further adjustment for frailty did not attenuate the estimates. The social support scale was not significantly associated with YOL or YAL after adjustment for social network score, and neither measure was associated with compression of disability. DISCUSSION In older adults, higher social network scores are significantly associated with longer life expectancy and disability-free life expectancy.
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Affiliation(s)
- Roma Bhatia
- University of Michigan Medical Center, Ann Arbor, MI, 48109, United States
| | - Calvin Hirsch
- University of California Davis Medical Center, Sacramento, CA, 95817, United States
| | - Alice M Arnold
- University of Washington, Seattle, WA, 98115, United States
| | - Anne B Newman
- University of Pittsburgh, Pittsburgh, PA, 15261, United States
| | - Kenneth J Mukamal
- Beth Israel Deaconess Medical Center, Boston, MA, 02446, United States.
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Han Y, Xu C, Zhang L, Wu Y, Fang Y. Expenditure projections for community home-based care services for older adults with functional decline in China. Int J Equity Health 2023; 22:143. [PMID: 37516872 PMCID: PMC10385915 DOI: 10.1186/s12939-023-01954-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/06/2023] [Indexed: 07/31/2023] Open
Abstract
INTRODUCTION Difficulty in identifying the functional status of older adults creates an imbalance between the supply and demand for community home-based care. Using a multi-level functional classification system to guide care cost measurement may optimize care resources and meet diverse eldercare demands. METHODS The Markov model was used to project the older population size in different functional decline (FD) statuses. The project cost and the man-hour costing method were combined to forecast the cost of community home-based care for older adults with FD. RESULTS The projected cost of eldercare increased from 1668.623 billion yuan in 2020 to 2836.754 billion yuan in 2035. By 2035, the total cost for community-based home care for those in pathological development of FD statuses such as "viability disorder," "acute disease," "somatic functional disorder," and "sub-disorder" was projected to be 1094.591 billion, 433.855 billion, 1256.236 billion, and 52.072 billion yuan, respectively, which is 1.24, 1.58, 1.78, and 0.49 times higher than the results by the man-hour costing method. Family caregiving costs are about three times those of professional caregivers. CONCLUSION The escalating cost of providing graded care for older adults, particularly by family caregivers, presenting a significant evidence for the need to optimize resource allocation and develop a robust human resources plan for community home-based care.
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Affiliation(s)
- Ying Han
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, Fujian, 361102, PR China
| | - Chuanhai Xu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, Fujian, 361102, PR China
| | - Liangwen Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, Fujian, 361102, PR China
- School of Economics, Xiamen University, 422 Siming South Road, Xiamen Fujian, 361005, PR China
| | - Yafei Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, Fujian, 361102, PR China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, Fujian, 361102, PR China.
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Baritello O, Stein H, Wolff LL, Hamann M, Völler H, Salzwedel A. Effect of multicomponent rehabilitation on independence and functioning in elderly patients with common age-associated diseases: protocol for a scoping review (REHOLD). BMJ Open 2023; 13:e068722. [PMID: 37202142 DOI: 10.1136/bmjopen-2022-068722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION Elderly patients after hospitalisation for acute events on account of age-related diseases (eg, joint or heart valve replacement surgery) are often characterised by a remarkably reduced functional health. Multicomponent rehabilitation (MR) is considered an appropriate approach to restore the functioning of these patients. However, its efficacy in improving functioning-related outcomes such as care dependency, activities of daily living (ADL), physical function and health-related quality of life (HRQL) remains unclarified. We outline the research framework of a scoping review designed to map the available evidence of the effects of MR on the independence and functional capacity of elderly patients hospitalised for age-related diseases in four main medical specialties beyond geriatrics. METHODS AND ANALYSIS The biomedical databases (PubMed, Cochrane Library, ICTRP Search Platform, ClinicalTrials) and additionally Google Scholar will be systematically searched for studies comparing centre-based MR with usual care in patients ≥75 years of age, hospitalised for common acute events due to age-related diseases (eg, joint replacement, stroke) in one of the specialties of orthopaedics, oncology, cardiology or neurology. MR is defined as exercise training and at least one additional component (eg, nutritional counselling), starting within 3 months after hospital discharge. Randomised controlled trials as well as prospective and retrospective controlled cohort studies will be included from inception and without language restriction. Studies investigating patients <75 years, other specialties (eg, geriatrics), rehabilitation definition or differently designed will be excluded. Care dependency after at least a 6-month follow-up is set as the primary outcome. Physical function, HRQL, ADL, rehospitalisation and mortality will be additionally considered. Data for each outcome will be summarised, stratified by specialty, study design and type of assessment. Furthermore, quality assessment of the included studies will be performed. ETHICS AND DISSEMINATION Ethical approval is not required. Findings will be published in a peer-reviewed journal and presented at national and/or international congresses. TRIAL REGISTRATION NUMBER https://doi.org/10.17605/OSF.IO/GFK5C.
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Affiliation(s)
- Omar Baritello
- Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
| | - Hanna Stein
- Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
| | - Lara Luisa Wolff
- Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
| | - Maria Hamann
- Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
| | - Heinz Völler
- Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
| | - Annett Salzwedel
- Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
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Han Y, Ye Z, Zhang L, Fang Y. The effect of PM 2.5 levels on continuum functional capability among older adults: Potential cause-effect or statistical associations. Arch Gerontol Geriatr 2023; 108:104917. [PMID: 36621241 DOI: 10.1016/j.archger.2022.104917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Since there is limited knowledge about health effects of the clean air policy (CAP, i.e., a series of emission-control actions) on continuum functional capacity (CFC) among the older adults on a large representative data, our research was to fill this gap. METHODS We used a continuous variable of airborne fine particulate matter (PM2.5) particles as a proxy for the CAP to evaluate the linear and non-linear effect of PM2.5 exposure on CFC of older adults, under the quasi-experimental framework of the temporal contrast between 2011 (before the CAP) and 2015 (after the CAP). Multiple environmental factors were considered and spline function was utilized to fit the spatial autocorrelations. A competing risk model was constructed to qualify the impact of PM2.5 on multidimensional disability. RESULTS After adjusting for potential confounders, a J-shaped association was found between PM2.5 concentration increase on CFC, with a threshold 2μg/m3. We also demonstrated that a 10-µg/m3 increase in PM2.5 concentration was related to a 14.0% (95% CI:0.00, 19.00%) increment risk in the functional decline. Similarly, the competing risk model presented a hazard ratio of multidimensional disability ranging from 1.707(0.928-4.141) at 40μg/m3 concentration of PM2.5 to 4.384 (1.970-9.755) over 80μg/m3. Stratified analyses showed that married men less than 80 years old in rural areas are more likely to be affected by PM2.5 exposure, where the influencing mechanism of air pollutant to outdoor and indoor activities might be the potential cause. CONCLUSION Implementing CAP might improve CFC, prevent the occurrence of disability, and update the air policy.
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Affiliation(s)
- Ying Han
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen Fujian 361102, China.
| | - Zirong Ye
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen Fujian 361102, China.
| | - Liangwen Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen Fujian 361102, China; Xiamen University, School of Economics, 422 Siming South Road, Xiamen Fujian 361005, China.
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen Fujian 361102, China.
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Choi K, Ko Y. Cross sectional association between cognitive frailty and disability among community-dwelling older adults: Focus on the role of social factors. Front Public Health 2023; 11:1048103. [PMID: 36844816 PMCID: PMC9947827 DOI: 10.3389/fpubh.2023.1048103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Background This study aimed to investigate the prevalence of cognitive frailty and the influence of social factors on the association between different levels of cognitive frailty and disability. Methods A nationally representative survey of non-institutionalized community-dwelling older adults in Korea was used. A total, 9,894 older adults were included in the analysis. We assessed the effects of social factors using social activities, social contacts, living arrangements, emotional support, and satisfaction with friends and neighbors. Results The prevalence of cognitive frailty was 1.6%, which was consistent with other population-based studies. Hierarchical logistic analysis demonstrated that the association between different levels of cognitive frailty and disability was attenuated when social participation, social contact, and satisfaction with friends and community were included in the model, and the magnitude of these effects differed across the levels of cognitive frailty. Discussion Considering the influence of social factors, interventions to enhance social relationships can help slow down the progression of cognitive frailty to disability.
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Affiliation(s)
- Kyungwon Choi
- Department of Nursing, Korea National University of Transportation, Chungju, Chungbuk, Republic of Korea
| | - Young Ko
- College of Nursing, Gachon University, Incheon, Republic of Korea,*Correspondence: Young Ko ✉
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Liao Z, Zhou H, He Z. The mediating role of psychological resilience between social participation and life satisfaction among older adults in China. BMC Geriatr 2022; 22:948. [PMID: 36482364 PMCID: PMC9733394 DOI: 10.1186/s12877-022-03635-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A significant correlation has been discovered between social participation and older adults' life satisfaction, but the relationships among social participation, psychological resilience, and life satisfaction remain to be confirmed. Therefore, this study aims to identify the relationship between social participation and life satisfaction for Chinese older adults and to analyse the possible mediating role of psychological resilience between these two aspects. METHODS Data on 15,779 people aged 65 years and above were extracted from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Social participation was classified into two levels: low-level involvement activities and high-level involvement activities. Hierarchical regression analysis was applied to analyse the correlations between the two levels of social participation and older adults' life satisfaction as well as the mediating effects of psychological resilience on this association. RESULTS The results indicate that two levels of social participation were each positively correlated with life satisfaction. Specifically, high-level involvement activities (β = 0.070, P < 0.001) were more strongly associated with life satisfaction than low-level involvement activities (β = 0.051, P < 0.001). Moreover, psychological resilience was found to partially mediate the association between low-level involvement activities and high-level involvement activities and life satisfaction. CONCLUSION A higher level of life satisfaction for older adults is related to participation in high-level involvement activities. Psychological resilience has a mediating effect on the association between two levels of older adults' social participation and life satisfaction. These findings suggest that the government and society should establish a more concrete understanding of the psychological resilience of older adults.
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Affiliation(s)
- Zhiliu Liao
- School of Public Affairs, Fujian Province, Xiamen University, Xiamen City, People's Republic of China
| | - Hanmeng Zhou
- School of Public Affairs, Fujian Province, Xiamen University, Xiamen City, People's Republic of China
| | - Zhifei He
- School of Politics and Public Administration, Southwest University of Political Science and Law, Chongqing, People's Republic of China.
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Beltz S, Gloystein S, Litschko T, Laag S, van den Berg N. Multivariate analysis of independent determinants of ADL/IADL and quality of life in the elderly. BMC Geriatr 2022; 22:894. [PMID: 36418975 PMCID: PMC9682836 DOI: 10.1186/s12877-022-03621-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study evaluated the determinants of disability and quality of life in elderly people who participated at the multi-centred RubiN project (Regional ununterbrochen betreut im Netz) in Germany. METHODS Baseline data of the subjects aged 70 years and older of the RubiN project were used and only subjects with complete data sets were considered for the ensuing analysis (complete case analysis (CCA)). Disability was examined using the concepts of ADL (activities of daily living) and IADL (instrumental activities of daily living). Subjects exhibiting one or more deficiencies in ADL respectively IADL were considered as ADL respectively IADL disabled. Quality of life was assessed using the WHOQOL-BREF and the WHOQOL-OLD. Applying multivariate analysis, sociodemographic factors, psychosocial characteristics as well as the functional, nutritional and cognitive status were explored as potential determinants of disability and quality of life in the elderly. RESULTS One thousand three hundred seventy-five subjects from the RubiN project exhibited data completeness regarding baseline data. ADL and IADL disability were both associated with the respective other construct of disability, sex, a reduced cognitive and functional status as well as domains of the WHOQOL-BREF. Furthermore, ADL disability was related to social participation, while IADL disability was linked to age, education and social support. Sex, ADL and IADL disability, income, social support and social participation as well as the functional status were predictors of the domain 'Physical Health' (WHOQOL-BREF). The facet 'Social Participation' (WHOQOL-OLD) was affected by both ADL and IADL disability, income, social participation, the nutritional and also the functional status. CONCLUSIONS Several potential determinants of disability and quality of life were identified and confirmed in this study. Attention should be drawn to prevention schemes as many of these determinants appear to be at least partly modifiable.
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Affiliation(s)
- Sebastian Beltz
- grid.5603.0Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Simone Gloystein
- grid.5603.0Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Litschko
- grid.5603.0Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Sonja Laag
- Department for Product Strategy/Development, BARMER Health Insurance, Wuppertal, Germany
| | - Neeltje van den Berg
- grid.5603.0Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
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Powell JM, Garvin MM, Lee NS, Kelly AM. Behavioral trajectories of aging prairie voles (Microtus ochrogaster): Adapting behavior to social context wanes with advanced age. PLoS One 2022; 17:e0276897. [PMCID: PMC9665403 DOI: 10.1371/journal.pone.0276897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Several studies using mice have examined the effects of aging on cognitive tasks, as well as sensory and motor functions. However, few studies have examined the influence of aging on social behavior. Prairie voles (Microtus ochrogaster) are a socially monogamous and biparental rodent that live in small family groups and are now among the most popular rodent models for studies examining social behavior. Although the social behavioral trajectories of early-life development in prairie voles have been well-studied, how social behavior may change throughout adulthood remains unknown. Here we examined behavior in virgin male and female prairie voles in four different age groups: postnatal day (PND) 60–80, 140–160, 220–240, and 300–320. All animals underwent testing in a novel object task, a dominance test, a resident-intruder test, and several iterations of social approach and social interaction tests with varying types of social stimuli (i.e., novel same-sex conspecific, novel opposite-sex conspecific, familiar same-sex sibling/cagemate, small group of novel same-sex conspecifics). We found that age influenced neophobia and dominance, but not social approach behavior. Further, we found that young adult, but not older adult, prairie voles adapt prosocial and aggressive behavior relative to social context, and that selective aggression occurs in relation to age even in the absence of a pair bond. Our results suggest that prairie voles calibrate social phenotype in a context-dependent manner in young adulthood and stop adjusting behavior to social context in advanced age, demonstrating that social behavior is plastic not only throughout early development, but also well into adulthood. Together, this study provides insight into age-related changes in social behavior in prairie voles and shows that prairie voles may be a viable model for studying the cognitive and physiological benefits of social relationships and social engagement in advanced age.
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Affiliation(s)
- Jeanne M. Powell
- Department of Psychology, Emory University, Atlanta, Georgia, United States of America
| | - Madison M. Garvin
- Department of Psychology, Emory University, Atlanta, Georgia, United States of America
| | - Nicholas S. Lee
- Department of Psychology, Emory University, Atlanta, Georgia, United States of America
| | - Aubrey M. Kelly
- Department of Psychology, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
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Lee CD, Park S, Foster ER. Subjective memory complaints and social participation among older adults: results from the health and retirement study. Aging Ment Health 2022; 26:1771-1777. [PMID: 34392755 DOI: 10.1080/13607863.2021.1961123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives:This study aims to examine whether subjective memory complaints (SMC) contribute to social participation among older adults.Method:The study sample was 4,713 community-dwelling older adults aged 65 years and older from four waves (2010, 2012, 2014, 2016) of the Health and Retirement Study. Hierarchical linear modeling analysis was used to examine the association of SMC with social participation after controlling for factors influencing social participation. Demographic factors (i.e. age, gender, and perceived socioeconomic status) were entered in block 1, health-related factors (i.e. health conditions, perceived health, instrumental activities of daily living, memory-immediate and delayed, and depressive symptoms) were entered in block 2, environmental factors (i.e. perceived social support and strain from spouse, child, family, and friend) were entered in block 3, and SMC was entered in block 4.Results:The result showed that factors significantly contributing to social participation are age (standardized β = -0.08, p < 0.01), perceived socioeconomic status (β = 0.16, p < 0.001), perceived health (β = 0.15, p < 0.001), instrumental activities of daily living (β = 0.12, p < 0.001), memory-immediate and delayed (β = 0.09, p < 0.001; β = 0.08, p < 0.001, respectively), social support from spouse and friend (β = 0.04, p < 0.05; β = 0.13, p < 0.001, respectively), social strain from friend (β = 0.07, p < 0.001), and SMC (β = -0.05, p < 0.001). The demographic factors explained 9.5%, health-related factors explained 8.5%, environmental factors explained 2.4%, and SMC explained 0.1% of the variance in social participation.Conclusion: This finding suggests that SMC may contribute to social participation in older adults.Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2021.1961123 .
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Affiliation(s)
- Chang Dae Lee
- Department of Occupational Therapy, New York University, New York, NY, USA
| | - Sangmi Park
- Wonju Severance Christian Hospital, Wonju, South Korea
| | - Erin R Foster
- Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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Does laughing with others lower the risk of functional disability among older Japanese adults? The JAGES prospective cohort study. Prev Med 2022; 155:106945. [PMID: 34973283 DOI: 10.1016/j.ypmed.2021.106945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/26/2021] [Accepted: 12/25/2021] [Indexed: 11/22/2022]
Abstract
While laughter is evoked mainly in social contexts, the potential link between laughter in daily life and health benefits is unclear. This study aimed to examine the association between laughter in daily life and the onset of functional disability among older adults in Japan. Data were obtained from a 6-year follow-up cohort of 12,571 participants (46.1% male) in the Japan Gerontological Evaluation Study, aged ≥65 years, who could independently perform daily activities. We evaluated their laughter in daily life from three perspectives: the types of situations in which people laugh, the number of situations in which people laugh with others, and the persons with whom people laugh. Using the Cox proportional hazards model, the risk of functional disability was estimated. A total of 1420 functional disabilities were observed during follow-up. After adjusting for potential confounders, participants who laughed with others (e.g., during conversations with friends) were at a reduced risk of functional disability (hazard ratio, 0.77; 95% confidence interval, 0.65-0.92) than those who laughed alone (e.g., during watching television). Similarly, the number of situations to laugh with others was inversely associated with the risk of functional disability (Ptrend < 0.001). Laughing in a conversation with friends reduced the risk of functional disability by approximately 30% compared to laughing alone. Overall, laughing with others was associated with a reduced risk of functional disability. Having more situations to laugh with others or at least the situation to laugh with friends might contribute to reducing the risk of functional disability later in life.
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Brown CJ, Rook KS. Does Diversity of Social Ties Really Matter More for Health and Leisure Activity than Number of Social Ties? Evidence from Later Adulthood. J Aging Health 2022; 34:831-843. [PMID: 35042381 DOI: 10.1177/08982643211066652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Claims that the diversity of social ties matters more for health than the sheer number of ties have largely gone untested. This study accordingly compared the unique associations of number versus diversity of social ties with key health-related outcomes: functional limitations and leisure activities. Additionally, positive and ambivalent ties were distinguished. METHODS Social networks, health, and leisure activities were assessed in a national sample of older adults (N = 874; ages 65-91). RESULTS Regression analyses revealed that number of ties related to each outcome at a magnitude comparable to, or exceeding, that of diversity in most models. For positive ties, number related more strongly than diversity to greater leisure activities. For ambivalent ties, number related more strongly than diversity to worse functional limitations. DISCUSSION Contrary to prevailing views, diversity of ties is not necessarily more important than number of ties. Findings extend scientific understanding and approaches to interventions.
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Affiliation(s)
- Colette J Brown
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Karen S Rook
- Department of Psychological Science, University of California, Irvine, CA, USA
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Gillsjö C, Nyström M, Palmér L, Carlsson G, Dalheim-Englund AC, Eriksson I. Balance in life as a prerequisite for community-dwelling older adults' sense of health and well-being after retirement: an interview-based study. Int J Qual Stud Health Well-being 2021; 16:1984376. [PMID: 34633914 PMCID: PMC8725713 DOI: 10.1080/17482631.2021.1984376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose This study aimed to describe community-dwelling older adults’ perceptions of health and well-being in life after retirement. Methods This study is part of a larger project using a mixed-methods design to address lifestyles’ influence on community-dwelling older adults’ health. Individual semi-structured interviews were conducted with 18 older adults in age 70 to 95 years. Data were analysed according to a phenomenographic approach. Results The results encompass four categories describing variations in community-dwelling older adults’ perceptions of health and well-being after retirement: feeling well despite illness and disease, interacting with and being useful for oneself and others, independently embracing opportunities and engaging in life, and maintaining a healthy lifestyle. Conclusions The absence of illness and disease is not a clear prerequisite for a sense of health and well-being. To promote and preserve health and well-being after retirement, older adults strived for—and coached themselves to uphold—a balance in life, focusing on not burdening others. This life orientation after retirement must be acknowledged by society at large, especially from an ageist perspective, and in health and social care to preserve and promote health and well-being.
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Affiliation(s)
- Catharina Gillsjö
- School of Health Sciences, University of Skövde, Skövde, Sweden.,College of Nursing, University of Rhode Island, USA
| | - Maria Nyström
- Faculty of Caring Science, Work Life and Social Welfare, Department of Caring Science, University of Borås, Sweden
| | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare, Department of Caring Science, University of Borås, Sweden
| | - Gunilla Carlsson
- Faculty of Caring Science, Work Life and Social Welfare, Department of Caring Science, University of Borås, Sweden
| | | | - Irene Eriksson
- School of Health Sciences, University of Skövde, Skövde, Sweden
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Subjective quality of life of Slovak men with physical disabilities: An age categories differences. ANTHROPOLOGICAL REVIEW 2021. [DOI: 10.2478/anre-2021-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The objective of the study was to analyze and compare the subjective quality of life (S-QOL) of Slovak men with physical disabilities through satisfaction with the quality of life domains (QOLDs) and the overall quality of life (QOL) assessment. The sample comprised of men with physical disabilities (n = 132), divided into 4 age categories: 19–29 yrs. (n = 59); 30–44 yrs. (n = 26); 45–59 yrs. (n = 24) and over 60 yrs. (n = 23). The Subjective Quality of Life Analysis (S-QUA-L-A) and The World Health Organisation Quality of Life User Manual (WHOQOL User Manual) were used as primary research methods. The findings of this study confirm differences in S-QOL in one QOLD as well as in the overall QOL between two from four age categories of men with physical disabilities. The 19–29 yrs. old men were significantly more satisfied in their lives with the Physical health domains and declared significantly higher overall QOL compare to 45–59 yrs. men. There were no significant differences found in S-QOL between other pair comparisons of the age categories of men with physical disabilities. The highest satisfaction in all age categories of men was declared by the domains of Social relation and Physical health and the highest dissatisfaction by the Psychological health and Environment domains. It is necessary to continue this line of this research field with stress on exploring the ways of psychological health increase as an integral part of S-QOL in men with physical disabilities. Future research should focus on life indicators that saturate the Environment domain, which should be positively affected in mens’ life.
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Doi T, Tsutsumimoto K, Nakakubo S, Kurita S, Ishii H, Shimada H. Associations Between Active Mobility Index and Disability. J Am Med Dir Assoc 2021; 23:1335-1341. [PMID: 34560017 DOI: 10.1016/j.jamda.2021.08.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To develop a questionnaire-based Active Mobility Index (AMI) to assess going-out behavior with physical and social activity among older adults, and to assess the criterion-related and predictive validity of the AMI. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS General community setting. Participants comprised 4432 older adults [mean age: 75.9 ± 4.3 (70-96) years; 2100 men (47.4%)]. METHODS AMI assessed life-space and activities in each life-space (distance from the respondent's home: <1 km, 1-10 km, or >10 km) according to physical or social activity during the past 1 month by noting frequency, purpose, type of transportation, interaction with others, and physical activity. Baseline characteristics and outcomes were compared by AMI score quartiles (highest: Q4). To examine the criterion-related validity of AMI, depressive symptoms, frailty, and cognitive function were assessed. During follow-up, incident disability was monitored by Long Term Care Insurance certification. RESULTS Lower scores (Q1-Q3 groups) were associated with more depressive symptoms, frailty, and cognitive impairment compared with the Q4 group (all P < .001). Multiple logistic regression analyses revealed significantly higher odds ratios in the Q1 group in all health adverse outcomes compared with the Q4 group [depressive symptoms, odds ratio (OR) 3.94, 95% confidence interval (CI) 2.95-5.28; frailty, OR 3.20, 95% CI 2.31-4.44; cognitive impairment, OR 1.28, 95% CI 1.04-1.57]. Cox proportional hazards modeling indicated that the Q1 group had a higher risk of incident disability compared with the group (hazard ratio 1.53, 95% CI 1.24-1.88). CONCLUSIONS AND IMPLICATIONS AMI to assess life-space with physical and social activity among older people was associated with depressive symptoms, frailty, and cognitive impairment. Lower AMI scores were associated with higher incident disability risk. Further studies are needed to elucidate whether AMI is causally associated with incident adverse health outcomes.
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Affiliation(s)
- Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hideaki Ishii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Ma R, Romano E, Vancampfort D, Firth J, Stubbs B, Koyanagi A. Physical Multimorbidity and Social Participation in Adult Aged 65 Years and Older From Six Low- and Middle-Income Countries. J Gerontol B Psychol Sci Soc Sci 2021; 76:1452-1462. [PMID: 33786598 PMCID: PMC8363032 DOI: 10.1093/geronb/gbab056] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Multimorbidity is common among older adults from low- and middle-income countries (LMICs). Social participation has a role in protecting against negative health consequences, yet its association with multimorbidity is unclear, particularly in LMICs. Thus, this study investigated the relationship between physical multimorbidity and social participation among older adults across 6 LMICs. METHOD Cross-sectional, community-based data including adults aged 65 years and older from 6 LMICs were analyzed from the WHO Study on Global AGEing and adult health survey. The association between 11 individual chronic conditions or the number of chronic conditions (independent variable) and social participation (range 0-10 with higher scores indicating greater social participation; dependent variable) was assessed by multivariable linear regression analysis. RESULTS 14,585 individuals (mean age 72.6 [SD 11.5] years; 54.9% females) were included. Among individual conditions, hearing problems, visual impairment, and stroke were significantly associated with lower levels of social participation. Overall, an increasing number of chronic conditions was dose-dependently associated with lower levels of social participation (e.g., ≥4 vs 0 conditions: β = -0.26 [95% CI = -0.39, -0.13]). The association was more pronounced among males than females. DISCUSSION Older people with multimorbidity had lower levels of social participation in LMICs. Future longitudinal studies are warranted to further investigate temporal associations, and whether addressing social participation can lead to better health outcomes among older people with multimorbidity in LMICs.
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Affiliation(s)
- Ruimin Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, UK
| | - Eugenia Romano
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, UK
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Belgium
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, UK
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, UK
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Spain
- Institució Catalana de Recerca i Estudis Avancats (ICREA), Barcelona, Spain
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Nicolson PJA, Sanchez-Santos MT, Bruce J, Kirtley S, Ward L, Williamson E, Lamb SE. Risk Factors for Mobility Decline in Community-Dwelling Older Adults: A Systematic Literature Review. J Aging Phys Act 2021; 29:1053-1066. [PMID: 34348224 DOI: 10.1123/japa.2020-0482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/18/2022]
Abstract
Mobility is essential to maintaining independence for older adults. This systematic review aimed to summarize evidence about self-reported risk factors for self-reported mobility decline; and to provide an overview of published prognostic models for self-reported mobility decline among community-dwelling older adults. Databases were searched from inception to June 2, 2020. Studies were screened by two independent reviewers who extracted data and assessed study quality. Sixty-one studies (45,187 participants) were included, providing information on 107 risk factors. High-quality evidence and moderate/large effect sizes for the association with mobility decline were found for older age beyond 75 years, the presence of widespread pain, and mobility modifications. Moderate-high quality evidence and small effect sizes were found for a further 21 factors. Three model development studies demonstrated acceptable model performance, limited by high risk of bias. These findings should be considered in intervention development, and in developing a prediction instrument for practical application.
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Experiences of social frailty among rural community-dwelling and assisted-living older adults: a qualitative study. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Although social frailty has been described from a theoretical perspective, the lived experiences of older adults regarding social frailty are yet unknown. In this paper, we aim to (a) gain more in-depth insights into community-dwelling and assisted-living older adults’ experiences of social frailty and (b) explore the differences in these experiences between these two groups. We conduct a thematic analysis of 38 interviews with community-dwelling and assisted-living older adults in rural villages the Netherlands. We structure our findings along three overarching themes which highlight different aspects of the social frailty experiences of our participants: (a) present resources and activities to fulfil social needs, (b) resources and activities that have been lost, and (c) how they manage and adapt to changes in resources and activities over time. Loneliness is only reported among the community-dwelling participants, while the loss of mobility and participation in (social) activities is experienced most strongly by the assisted-living participants. These findings challenge the widespread policies and practices of ageing in place. We conclude that for some older adults, living in assisted arrangements is preferred over ageing in place, as doing so can prevent social frailty. The key reason for this is that life in assisted living is likely to bring about new social resources and activities, which may serve to fulfil the social needs of older adults.
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Al Gilani S, Tingö L, Kihlgren A, Schröder A. Mental health as a prerequisite for functioning as optimally as possible in old age: A phenomenological approach. Nurs Open 2021; 8:2025-2034. [PMID: 33423387 PMCID: PMC8363343 DOI: 10.1002/nop2.698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/15/2020] [Accepted: 10/22/2020] [Indexed: 01/07/2023] Open
Abstract
Aim To describe the impact of mental health on the ability to function optimally among older adults experiencing mental health issues. Design This study had a descriptive qualitative design. Methods Six older females with a Hospital Anxiety and Depression Scale (HADS) score of ≥8 on either of the subscales (depression or anxiety) participated in individual interviews. All data were analysed using a phenomenological approach influenced by Giorgi. Results The phenomenological analysis led to a structured synthesis comprising the following three themes: (a) life situations affecting mental health, (b) consequences of mental health in everyday life and (c) strategies for maintaining mental health.
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Affiliation(s)
- Samal Al Gilani
- Nutrition and Physical Activity Research CentreFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- School of Health and SciencesFaculty of Medicine and HealthUniversity Health Care Research CentreÖrebro UniversityÖrebroSweden
| | - Lina Tingö
- Nutrition and Physical Activity Research CentreFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- Nutrition Gut Brain Interactions Research CentreFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Annica Kihlgren
- Nutrition and Physical Activity Research CentreFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- School of Health and SciencesFaculty of Medicine and HealthUniversity Health Care Research CentreÖrebro UniversityÖrebroSweden
| | - Agneta Schröder
- Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- Department of Health SciencesFaculty of Medicine and Health ScienceNTNU – Norwegian University of Science and TechnologyGjøvikNorway
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Ida S, Kaneko R, Imataka K, Fujiwara R, Murata K. Are diabetes-related factors associated with the social roles of elderly patients with diabetes? J Diabetes Complications 2021; 35:107759. [PMID: 33616041 DOI: 10.1016/j.jdiacomp.2020.107759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/03/2020] [Accepted: 09/16/2020] [Indexed: 01/18/2023]
Abstract
AIMS To identify factors associated with social roles, including glycemic parameters, diabetic complications, and diabetes treatment, in elderly patients with diabetes. METHODS We included diabetic patients aged ≥65 years undergoing outpatient treatment at Ise Red Cross Hospital. Functional capacity was assessed using the social role subscale, included in the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). Multiple regression analyses were performed using social roles as dependent variables and age, body mass index, HbA1c, glycoalbumin/HbA1c, hypertension, dyslipidemia, diabetic microangiopathy, cardiovascular disease, depression, sleep disturbance, living alone, frailty, diabetic drug as explanatory variables. RESULTS In total, 367 patients (208 males and 159 females) were included. In men, diabetic nephropathy (coefficient, -0.496; 95% confidence interval (CI), -0.900 to -0.091; P = 0.017), depression (coefficient, -0.497; 95% CI, -0.942 to -0.051; P = 0.029), and frailty (coefficient, -0.595; 95% CI, -1.048 to -0.142; P = 0.010) were associated with a decline in social roles. In women, frailty (coefficient, -0.826; 95% CI, -1.306 to -0.346; P = 0.001) was associated with a decline in social roles. CONCLUSIONS Social roles may decline in elderly male diabetic patients with nephropathy, depression, and frailty and in elderly female diabetic patients with frailty.
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Affiliation(s)
- Satoshi Ida
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2 Funae, 1-chome, Ise-shi, Mie 516-8512, Japan.
| | - Ryutaro Kaneko
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2 Funae, 1-chome, Ise-shi, Mie 516-8512, Japan
| | - Kanako Imataka
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2 Funae, 1-chome, Ise-shi, Mie 516-8512, Japan
| | - Ryoko Fujiwara
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2 Funae, 1-chome, Ise-shi, Mie 516-8512, Japan
| | - Kazuya Murata
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2 Funae, 1-chome, Ise-shi, Mie 516-8512, Japan.
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Toyama M, Fuller HR, Owino J. Longitudinal Implications of Social Integration for Age and Gender Differences in Late-Life Physical Functioning. Int J Aging Hum Dev 2020; 94:169-192. [PMID: 33307713 DOI: 10.1177/0091415020980755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social integration has documented benefits for late-life health; yet, little is known about its impacts on trajectories of physical functioning. This study examines age and gender differences in the longitudinal associations between social integration and activities of daily living (ADLs) using a hierarchical linear model with three waves of survey data collected over 4 years from the Social Integration and Aging Study (N = 400; baseline mean age = 80.3). Findings indicated some interaction effects of age, gender, and/or social integration on ADL trajectories. Among those of more advanced age, women showed greater increases in ADL limitations than men, and individuals with lower social integration experienced greater increases in ADL limitations than those with higher social integration. Neither of these patterns were found among younger older adults. This study highlights the benefits of longitudinal research on social integration and the need to explore practical interventions for promoting social integration particularly among the oldest older adults.
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Affiliation(s)
- Masahiro Toyama
- 3323 Division of Natural Sciences and Mathematics, University of the Ozarks, Clarksville, AR, USA
| | - Heather R Fuller
- 174543 Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
| | - Jonix Owino
- 174543 Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
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Yu B, Steptoe A, Niu K, Jia X. Social Isolation and Loneliness as Risk Factors for Grip Strength Decline Among Older Women and Men in China. J Am Med Dir Assoc 2020; 21:1926-1930. [DOI: 10.1016/j.jamda.2020.06.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/03/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022]
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Dockx YJC, Molenaar EALM, Barten DJJA, Veenhof C. Discriminative validity of the Core outcome set functional independence in a population of older adults. BMC Geriatr 2020; 20:309. [PMID: 32847518 PMCID: PMC7450554 DOI: 10.1186/s12877-020-01705-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinicians are currently challenged to support older adults to maintain a certain level of Functional Independence (FI). FI is defined as "functioning physically safely and independent from another person, within one's own context". A Core Outcome Set was developed to measure FI. The purpose of this study was to assess discriminative validity of the Core Outcome Set FI (COSFI) in a population of Dutch older adults (≥ 65 years) with different levels of FI. Secondary objective was to assess to what extent the underlying domains 'coping', 'empowerment' and 'health literacy' contribute to the COSFI in addition to the domain 'physical capacity'. METHODS A population of 200 community-dwelling older adults and older adults living in residential care facilities were evaluated by the COSFI. The COSFI contains measurements on the four domains of FI: physical capacity, coping, empowerment and health literacy. In line with the COSMIN Study Design checklist for Patient-reported outcome measurement instruments, predefined hypotheses regarding prediction accuracy and differences between three subgroups of FI were tested. Testing included ordinal logistic regression analysis, with main outcome prediction accuracy of the COSFI on a proxy indicator for FI. RESULTS Overall, the prediction accuracy of the COSFI was 68%. For older adults living at home and depending on help in (i)ADL, prediction accuracy was 58%. 60% of the preset hypotheses were confirmed. Only physical capacity measured with Short Physical Performance Battery was significantly associated with group membership. Adding health literacy with coping or empowerment to a model with physical capacity improved the model significantly (p < 0.01). CONCLUSIONS The current composition of the COSFI, did not yet meet the COSMIN criteria for discriminative validity. However, with some adjustments, the COSFI potentially becomes a valuable instrument for clinical practice. Context-related factors, like the presence of a spouse, also may be a determining factor in this population. It is recommended to include context-related factors in further research on determining FI in subgroups of older people.
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Affiliation(s)
- Yvonne J C Dockx
- Physical Therapy Sciences, program in clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Esther A L M Molenaar
- Department Innovation of Human Movement Care, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Di-Janne J A Barten
- Department Innovation of Human Movement Care, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Cindy Veenhof
- Department Innovation of Human Movement Care, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
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Saju M, Benny AM, Preet Allagh K, Joseph B, Amuthavalli Thiyagarajan J. Relationship between neighbourhood cohesion and disability: findings from SWADES population-based survey, Kerala, India. F1000Res 2020; 9:700. [PMID: 32832072 PMCID: PMC7424915 DOI: 10.12688/f1000research.25073.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2020] [Indexed: 01/09/2023] Open
Abstract
Background: The burden of disability on individuals and society is enormous in India, and informal care systems try to reduce this burden. This study investigated the association between neighbourhood cohesion and disability in a community-based population in Kerala, India. To the best of our knowledge, no previous studies have examined this association in India. Methods: A cross-sectional household survey was conducted with 997 participants aged 30 years and above, in Kerala. Neighbourhood cohesion was assessed by three scales: trust, community participation, and perceived safety. Functional ability was measured by WHODAS 2.0. Explanatory covariates included chronic disease conditions, age, gender, education, income, and mental health conditions. Results: Of 997 participants (37% male; mean age, 53.9 [range, 30-90] years), the majority were married or cohabiting. Univariate analysis showed functional ability to be positively associated with most demographic and health characteristics. However, after adjustment, only social cohesion, age, income, education, chronic diseases and mental health conditions remained significant. Mediation analysis showed the effect of personal and health characteristics on functional ability as mediated by social cohesion. Conclusion: Social cohesion is an important moderator of functional ability. Interventions targeting the creation of stronger ties among neighbours and a sense of belonging should be scaled-up and evaluated in future research.
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Affiliation(s)
- M.D. Saju
- Rajagiri College of Social Sciences (Autonomous), Cochin, Kerala, 683104, India
- Rajagiri International Centre for Consortium Research in Social Care (ICRS), Rajagiri College of Social Sciences, Cochin, Kerala, 683104, India
| | - Anuja Maria Benny
- Rajagiri College of Social Sciences (Autonomous), Cochin, Kerala, 683104, India
- Rajagiri International Centre for Consortium Research in Social Care (ICRS), Rajagiri College of Social Sciences, Cochin, Kerala, 683104, India
| | - Komal Preet Allagh
- Rajagiri College of Social Sciences (Autonomous), Cochin, Kerala, 683104, India
- Rajagiri International Centre for Consortium Research in Social Care (ICRS), Rajagiri College of Social Sciences, Cochin, Kerala, 683104, India
| | - Binoy Joseph
- Rajagiri College of Social Sciences (Autonomous), Cochin, Kerala, 683104, India
- Rajagiri International Centre for Consortium Research in Social Care (ICRS), Rajagiri College of Social Sciences, Cochin, Kerala, 683104, India
| | - Jotheeswaran Amuthavalli Thiyagarajan
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK, SE5 9NU, UK
- Department of Maternal, New-born, child, adolescent health and aging, World Health Organization, Avenue Appia 20, Geneva, CH-1211, Switzerland
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SARS-CoV-2 self-isolation: recommendations for people with a vision impairment. Eye (Lond) 2020; 34:1183-1184. [PMID: 32350453 PMCID: PMC7189829 DOI: 10.1038/s41433-020-0917-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 11/08/2022] Open
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Mournet AM, Bower E, Van Orden KA. Domains of Functional Impairment and Their Associations with Thwarted Belonging and Perceived Burden in Older Adults. Clin Gerontol 2020; 43:95-103. [PMID: 31397645 PMCID: PMC6923585 DOI: 10.1080/07317115.2019.1650406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Functional impairment and social disconnection are risk factors for suicide in later life. This paper examines associations between domains of functional impairment and two forms of social disconnection that are empirically linked to suicide in later life - low (or thwarted) belonging and perceived burden on others.Methods: Participants are 62 older primary care patients (67.68% female, mean age = 72.05) who endorsed feeling lonely or like a burden. Participants completed self-report measures of low belonging and perceived burden (INQ-R) and domains of functional impairment (WHODAS 2.0) at a single time point.Results: Greater perceived burden was associated with greater impairment in activities of daily living ("self-care"), while greater thwarted belonging was associated with greater impairment in social functioning, when controlling for depressive symptoms and age. Domains of mobility, cognition and social participation were not associated with either belonging or perceived burden.Conclusions: Impairment in self-care (ADLs) and social functioning may be more strongly associated with perceived burden and thwarted belonging than other domains of functional impairment.Clinical Implications: Considering specific domains of functional impairment - rather than functioning more broadly - may facilitate tailored interventions to target suicide risk.
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Affiliation(s)
- Annabelle M Mournet
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Emily Bower
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Kimberly A Van Orden
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
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Jacobsen KK, Jepsen R, Lembeck MA, Nilsson C, Holm E. Associations between the SHARE frailty phenotype and common frailty characteristics: evidence from a large Danish population study. BMJ Open 2019; 9:e032597. [PMID: 31619433 PMCID: PMC6797251 DOI: 10.1136/bmjopen-2019-032597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Frailty is a major clinical geriatric syndrome associated with serious adverse events including functional disability, falls, hospitalisation, increased morbidity and mortality. The aim of this study was to study associations between a frailty phenotype and frailty characteristics well known from the literature. DESIGN Registry-based cross-sectional study. SETTING The target population consists of inhabitants above the age of 50 living in the Danish municipalities of Lolland and Guldborgsund. Excluded are incapacitated people, inhabitants unable to understand Danish or English and inhabitants without a permanent residence. PARTICIPANTS 7327 individuals aged 50+ years were included. OUTCOME MEASURES We examined associations between the frailty measurement and factors known to be associated with frailty: sex, age, income insufficiency, education, comorbidity, self-assessed health, morbidity and mortality. RESULTS 7327 individuals aged 50+ years were included. Of these, 6.5% had ≥3 frailty components (frail), 46.7% had 1-2 components (prefrail) and 46.9% had none (non-frail). Those who were frail were older and more likely female than those who were non-frail or prefrail. There was a stepwise decrease in educational level, and in self-assessed health with increasing frailty status, and a stepwise increase in difficulty in making ends meet, number of hospital contacts and mortality with increasing frailty status, p<0.0001 for each comparison. Compared with individuals who were non-frail, mortality was higher among those who were prefrail (HR: 2.90; 95% CI: 1.30 to 6.43) or frail (HR: 8.21; 95% CI: 3.37 to 20.0). CONCLUSIONS Based on these findings, we consider the Lolland-Falster Health Study frailty assessment a valid instrument demonstrating the same characteristics as other validated frailty measures concerning associations with sex, age, income insufficiency, education, comorbidity, self-assessed health, morbidity and mortality. TRIAL REGISTRATION NUMBER NCT02482896.
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Affiliation(s)
| | - Randi Jepsen
- Lolland-Falster Helath Study, Nykøbing F Sygehus, Nykobing, Denmark
| | | | - Charlotte Nilsson
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Holm
- Internal Medicine, Nykøbing F Sygehus, Nykobing, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Kobenhavns, Denmark
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Vusirikala A, Ben-Shlomo Y, Kuh D, Stafford M, Cooper R, Morgan GS. Mid-life social participation and physical performance at age 60-64: evidence from the 1946 British Birth Cohort Study. Eur J Public Health 2019; 29:986-992. [PMID: 30726911 DOI: 10.1093/eurpub/ckz005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous studies linking social activity and disability have been limited by focussing on self-reported physical performance in older adults (>65). We examined whether social participation in mid-life is associated with objective and subjective measures of physical performance in older age. METHODS Participants of the Medical Research Council National Survey of Health and Development reported their involvement in social activities at ages 43 and 60-64 years; frequency of such involvement was classified into thirds. Physical performance was measured at age 60-64 using: grip strength; standing balance; chair rises; timed get-up-and-go; self-reported physical function from the Short Form-36. Multivariable regression was used to examine longitudinal associations between social participation and each physical performance measure. We also investigated whether change in social participation between 43 and 60-64 was associated with each outcome. RESULTS In fully adjusted models, higher frequency of social participation at 43 was associated with faster chair rise (1.42 repetitions/min, 95% CI 0.45-2.39) and timed get-up-and-go speed (2.47 cm/s, 95% CI 0.27-4.67) and lower likelihood of self-report limitations (OR of low physical function 0.67, 95% CI 0.50-0.91) at 60-64 compared with low frequency. Better performance in objectively measured outcomes was observed only if higher social participation persisted over time whereas lower odds of self-reported limitations were found in all groups when compared to those with persistently low participation (ORs 0.43-0.56, all P≤0.02). CONCLUSION Our findings suggest that associations between higher levels of social participation in mid-life and better physical performance exist only if this social participation persists through to older age.
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Affiliation(s)
- A Vusirikala
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Y Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - D Kuh
- Medical Research Council Unit for Lifelong Health and Ageing at University College London (UCL), UK
| | - M Stafford
- Medical Research Council Unit for Lifelong Health and Ageing at University College London (UCL), UK
| | - R Cooper
- Medical Research Council Unit for Lifelong Health and Ageing at University College London (UCL), UK
| | - G S Morgan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Toyama M, Fuller HR. Longitudinal Stress-Buffering Effects of Social Integration for Late-Life Functional Health. Int J Aging Hum Dev 2019; 91:501-519. [DOI: 10.1177/0091415019871196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Stress can negatively affect multiple aspects of health, including functional health, among older adults, who are likely to face unique, age-related stressful experiences. Previous research has addressed the protective effects of social relations (i.e., social ties, social participation, and social integration) for physical and mental health outcomes, yet few studies have examined functional health. This study aimed to investigate the longitudinal stress-buffering effects of social integration on late-life functional health. Using three-wave data from 399 older adults (aged older than 60 years), two-level hierarchical linear modeling analysis was conducted and the results indicated that in addition to its main effect on functional (activity of daily living) limitations, social integration moderated the negative effect of stress on the longitudinal trajectory of functional limitations. The findings suggest important directions of future research to identify the mechanisms of such buffering effects over time and develop effective interventions to enhance late-life functional health while promoting social integration.
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Affiliation(s)
- Masahiro Toyama
- Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
| | - Heather R. Fuller
- Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
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Park H, Jang IY, Lee HY, Jung HW, Lee E, Kim DH. Screening Value of Social Frailty and Its Association with Physical Frailty and Disability in Community-Dwelling Older Koreans: Aging Study of PyeongChang Rural Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2809. [PMID: 31394719 PMCID: PMC6720732 DOI: 10.3390/ijerph16162809] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/26/2019] [Accepted: 08/04/2019] [Indexed: 11/29/2022]
Abstract
Population aging is a challenge, therefore efficient frailty screening has been increasingly emphasized for mass older populations. This study aimed to evaluate the prevalence of social frailty and its association with physical frailty, geriatric syndromes and activity of daily living (ADL) disability in community-dwelling older adults. A cross-sectional study was conducted with 408 older adults (mean age, 75 years; 58% female) in the Aging Study of PyeongChang Rural Area. A five-item social frailty index was administered (range: 0-5); (1) going out less frequently; (2) rarely visiting the homes of friends; (3) feeling unhelpful to friends and family; (4) being alone; and (5) not talking with someone every day. Social frailty was defined as ≥2 positive responses. Physical frailty was assessed according to the Cardiovascular Health Study frailty phenotype criteria. We used logistic regression to examine whether social frailty can identify older adults with common geriatric syndromes including ADL disability, independently of age, gender, and physical frailty. Social frailty was present in 20.5% (14.5% in male and 25.0% in female) and 11.5% was not overlapped with physical frailty. Social frailty increased risk of ADL disability (odds ratio, 2.53; 95% confidence interval, 1.26-5.09) and depressed mood (odds ratio, 4.01; 95% confidence interval, 1.30-12.39) independently of age, gender, and physical frailty. The predictive power for disability was maximized by using both frailty indices (C statistic 0.73) compared with either frailty index alone (C statistic: 0.71 for social frailty and 0.68 for physical frailty). Social frailty screening is important as it can identify frail older adults who are not captured by demographic characteristics and physical frailty. Moreover, assessment of both social frailty and physical frailty can better detect disability and geriatric syndromes.
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Affiliation(s)
- Hyungchul Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Il-Young Jang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
- Pyeongchang Health Center & Country Hospital, Gangwon-do 25377, Korea
| | - Hea Yon Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Hee-Won Jung
- Division of geriatrics, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Eunju Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Dae Hyun Kim
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131, USA
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
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Steere HK, Quach L, Grande L, Bean JF. Evaluating the Influence of Social Engagement on Cognitive Impairment and Mobility Outcomes Within the Boston RISE Cohort Study. Am J Phys Med Rehabil 2019; 98:685-691. [PMID: 31318749 PMCID: PMC6649680 DOI: 10.1097/phm.0000000000001175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We investigated the associations between mild cognitive impairment (MCI), social engagement (SE), and mobility. DESIGN We evaluated data from a cohort study of older adult primary care patients (N = 430). Outcomes included self-reported function (Late-Life Function Instrument [LLFI]) and performance-based mobility (Short Physical Performance Battery score [SPPB]). Linear regression models evaluated the association between MCI and mobility, MCI and SE, mobility measures and SE, and whether SE mediated the association between MCI status and mobility. RESULTS Participants with MCI had significantly lower mobility and lower SE as compared with those without MCI (LLFI: 53.5 vs. 56.9, P < 0.001; SPPB: 7.9 vs. 9.3, P < 0.001; SE score: 44.9 vs. 49.0, P < 0.001). Mild cognitive impairment was significantly associated with both LLFI and SPPB (LLFI β = -2.93, P < 0.001; SPPB β = -1.26, P < 0.001) and SE (β = -3.20, P < 0.001). Social engagement was significantly associated with both LLFI and SPPB (LLFI β = 0.22; P < 0.001; SPPB β = 0.08; P < 0.001). There was a positive association between SE and mobility (P< 0.05). A mediator effect of SE was supported when evaluating the association between MCI and mobility. CONCLUSIONS Among older adult primary care patients at risk for mobility decline, higher levels of SE mitigate the association between MCI and mobility.
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Affiliation(s)
- Hannah K Steere
- From the Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts (HKS, JFB); Spaulding Rehabilitation Hospital, Charlestown, Massachusetts (HKS, JFB); Massachusetts Veterans Epidemiology Research and Information Center, Geriatric Research Education and Clinical Center, Boston, Massachusetts (LQ, JFB); Psychology Service, VA Boston Healthcare System, Boston, Massachusetts (LG); and Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts (LG)
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Lau YW, Vaingankar JA, Abdin E, Shafie S, Jeyagurunathan A, Zhang Y, Magadi H, Ng LL, Chong SA, Subramaniam M. Social support network typologies and their association with dementia and depression among older adults in Singapore: a cross-sectional analysis. BMJ Open 2019; 9:e025303. [PMID: 31154300 PMCID: PMC6549623 DOI: 10.1136/bmjopen-2018-025303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To examine the social support network type and its associations with depression and dementia among older adults in Singapore. DESIGN This study is a cross-sectional analysis of data from the Well-being of the Singapore Elderly study. The Practitioner Assessment of Network Type was used to identify five social support network types. Odds Ratios (OR) of dementia and depression were estimated with logistic regression and multinomial logistic regression, respectively, adjusted for sociodemographic variables. SETTING Singapore. OUTCOME MEASURES 10/66 criteria and Automated Geriatric Examination for Computer Assisted Taxonomy computer algorithm. PARTICIPANTS 2421 older adults aged 60 years and above, and their informants. RESULTS Logistic regression revealed that as compared with participants in the family dependent social support network type, those in the locally integrated social support network type were negatively associated with dementia. It was observed that it is the older adults' perception of the quality of social interaction that influences the likelihood of depression. CONCLUSION The social support network typology presents knowledge about the older adults' social network profile and their cognitive functioning-ability which would help stakeholders better identify older adults who might be at risk of cognitive decline or experiencing delay in diagnosis of dementia.
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Affiliation(s)
- Ying Wen Lau
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Harish Magadi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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Boen F, Pelssers J, Scheerder J, Vanbeselaere N, Vos S, Hurkmans E, Smits T, Fransen K. Does Social Capital Benefit Older Adults' Health and Well-Being? The Mediating Role of Physical Activity. J Aging Health 2019; 32:688-697. [PMID: 31092109 DOI: 10.1177/0898264319848638] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To assess whether social capital benefits older adults' self-rated health and well-being and whether physical activity mediates this relation. Methods: A survey study was conducted among members of a sociocultural organization (age ≥55 years), both cross-sectionally (baseline Time 1; N = 959) and longitudinally (3-year follow-up Time 2; N = 409). Results: Specific indicators of social capital were positively, though modestly, related to health and well-being at Time 1 and Time 2. Experienced connectedness with age peers emerged as the strongest predictor. Physical activity only mediated the relation with experienced safety in society. Discussion: The relative importance of older adults' experienced connectedness with their age peers underlines the importance of internalized group membership as a determinant of their health and well-being. Physical activity seems to play only a minor mediating role.
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Affiliation(s)
- F Boen
- KU Leuven, Leuven, Belgium
| | | | | | | | - S Vos
- KU Leuven, Leuven, Belgium.,Fontys University of Applied Sciences, Eindhoven, The Netherlands.,Eindhoven University of Technology, Eindhoven, The Netherlands
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Quach LT, Ward RE, Pedersen MM, Leveille SG, Grande L, Gagnon DR, Bean JF. The Association Between Social Engagement, Mild Cognitive Impairment, and Falls Among Older Primary Care Patients. Arch Phys Med Rehabil 2019; 100:1499-1505. [PMID: 30825422 DOI: 10.1016/j.apmr.2019.01.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 01/10/2019] [Accepted: 01/23/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations. DESIGN Cross sectional analysis using baseline data from an observational cohort study. SETTING Primary care. PARTICIPANTS Community-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y). MAIN OUTCOME MEASURES The number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100. RESULTS MCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P<.05). There was a statistically significant interaction between SE and MCI on the rate of falls (P<.01), such that at a high level of SE, MCI was not statistically associated with falls (P=.83). In participants with lower levels of SE, MCI is associated with 1.3 times greater rate of falls (P<.01). CONCLUSIONS While MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.
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Affiliation(s)
- Lien T Quach
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, MA; Department of Gerontology, University of Massachusetts Boston, Boston, MA.
| | - Rachel E Ward
- Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Harvard Medical School, Cambridge, MA
| | - Mette M Pedersen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Denmark
| | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Cambridge, MA
| | - Laura Grande
- Beth Israel Deaconess Medical Center, Boston, MA; VA Boston Healthcare System, Boston, MA
| | - David R Gagnon
- Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, MA; Department of Biostatistics, Boston University, Boston, MA
| | - Jonathan F Bean
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Harvard Medical School, Cambridge, MA
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Wood N, McMunn A, Webb E, Stafford M. Marriage and physical capability at mid to later life in England and the USA. PLoS One 2019; 14:e0209388. [PMID: 30673714 PMCID: PMC6343866 DOI: 10.1371/journal.pone.0209388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Married people have lower rates of mortality and report better physical and mental health at older ages, compared to their unmarried counterparts. However, there is limited evidence on the association between marriage and physical capability, the ability to carry out the tasks of daily living, which is predictive of future mortality and social care use. We investigate the association between marital status and physical capability at mid to later life in England and the United States. METHODS We examine the association between marriage and physical capability at mid to later life in England and the USA using two performance-based measures of physical capability: grip strength and walking speed. Multiple linear regression was carried out on Wave 4 (2008) of the English Longitudinal Study of Ageing (ELSA) and Waves 8 and 9 (2006 and 2008) of the US Health and Retirement Study (HRS). RESULTS In age adjusted models married men and women had better physical capability than their unmarried counterparts. Much of the marriage advantage was explained by the greater wealth of married people. However, remarried men were found to have stronger grip strength and widowed and never married men had a slower walking speed than men in their first marriage, which was not explained by wealth, demographic and socioeconomic characteristics, health behaviours, chronic disease or depressive symptoms. There were no differences in the association between England and the USA. CONCLUSIONS Marriage may be an important factor in maintaining physical capability in both England and the USA, particularly because of the greater wealth which married people have accrued by the time they reach older ages. The grip strength advantage for remarried men may be due to unobserved selective factors into remarriage.
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Affiliation(s)
- Natasha Wood
- CLOSER, UCL Institute of Education, London, United Kingdom
| | - Anne McMunn
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Elizabeth Webb
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Crestani C, Masotti V, Corradi N, Schirripa ML, Cecchi R. Suicide in the elderly: a 37-years retrospective study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:68-76. [PMID: 30889157 PMCID: PMC6502164 DOI: 10.23750/abm.v90i1.6312] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 03/27/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND The rates of suicide increase with age and reach their highest levels in the oldest age groupings and are sufficiently large for them to constitute a public health concern. The number of deaths due to suicides after the age of 60 years in Italy is 1,775 (41.36%) in 2013; there is a constant increase of elder population over the last ten years and elderly are almost twice of young. It is in this context that suicide arises, a risk factor during old age. METHOD This is a retrospective study of autopsy and police reports of suicide from January 1979 through December 2015. Data about suicides after the age of 60 years was collected from the Archives of the Legal Medicine of the University of Parma, a Northern Italian city. Trend and characteristics (age, sex, marital status, pathological factors and method of suicide) were assessed. RESULTS A total of 538 cases (394 males, 144 females) were identified. Male sex correlates to a higher suicidal risk, with a male-female ratio of 2.74:1. The highest risk of suicide is observed in the age between 70 and 79 years. Pathological factors were revealed in 427 cases (physical state for 194 cases, mental state for 233 cases); mental illness was related significantly to suicidal risk. Hanging is the most common suicide method (175 cases), followed by fall from height (130 cases), drowning (101 cases) and use of firearms (56 cases); differences regarding methods employed were detected between males and females. The choice of method sometimes is indicative of a clear decision, while other times it is strictly linked to the availability of the means. CONCLUSIONS Suicidal behavior seems to be the product of the interaction of many factors, such as biological or psychological diseases or painful events. The presence of chronic and debilitating diseases, often accompanied by profound psychological suffering, is a powerful stimulus for suicide among men, whereas mental state is a significant risk factor for women, with the majority suffering from depression. The psychological and the biological changes, the cognitive deficits and the common diseases facilitate the structuring of depressive characteristics.
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Affiliation(s)
- Carlo Crestani
- Department of Biomedical, Biotechnological and Translational Sciences. Unit of Legal Medicine, Faculty of Medicine and Surgery, University of Parma, Italy.
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Makizako H, Kubozono T, Kiyama R, Takenaka T, Kuwahata S, Tabira T, Kanoya T, Horinouchi K, Shimada H, Ohishi M. Associations of social frailty with loss of muscle mass and muscle weakness among community-dwelling older adults. Geriatr Gerontol Int 2018; 19:76-80. [DOI: 10.1111/ggi.13571] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 09/21/2018] [Accepted: 10/08/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences; Faculty of Medicine, Kagoshima University; Kagoshima Japan
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension; Graduate School of Medical and Dental Sciences, Kagoshima University; Kagoshima Japan
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences; Faculty of Medicine, Kagoshima University; Kagoshima Japan
| | - Toshihiro Takenaka
- Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital; Kagoshima Japan
| | - So Kuwahata
- Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital; Kagoshima Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences; Faculty of Medicine, Kagoshima University; Kagoshima Japan
| | | | | | - Hiroyuki Shimada
- Department of Preventive Gerontology; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology; Obu Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension; Graduate School of Medical and Dental Sciences, Kagoshima University; Kagoshima Japan
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Corbett DB, Rejeski WJ, Tudor-Locke C, Glynn NW, Kritchevsky SB, McDermott MM, Church TS, Fielding RA, Gill TM, King AC, Miller ME, Chen H, Pahor M, Manini TM. Social Participation Modifies the Effect of a Structured Physical Activity Program on Major Mobility Disability Among Older Adults: Results From the LIFE Study. J Gerontol B Psychol Sci Soc Sci 2018; 73:1501-1513. [PMID: 28482106 PMCID: PMC6178963 DOI: 10.1093/geronb/gbx051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 04/21/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate whether baseline social participation modifies the effect of a long-term structured physical activity (PA) program on major mobility disability (MMD). Methods 1,635 sedentary adults (70-89 years) with physical limitations were randomized to either a structured PA or health education (HE) intervention. Social participation was defined categorically at baseline. High social participation was defined as attending organized group functions at least once per week and visiting with noncohabitating friends and family ≥7 hr per week. Anything less was considered limited social participation. Participants performed a standardized walking test at baseline and every 6 months for up to 42 months. MMD was defined as the loss in the ability to walk 400 m. Results There was a significant intervention by social participation interaction (p = .003). Among individuals with high levels of social participation, those randomized to PA had significantly lower incidence of MMD (hazard ratio [HR], 0.43 [95% confidence interval (CI), 0.27-0.68]; p < .01) than those randomized to HE. Individuals with limited social participation showed no mobility benefit of the PA intervention when compared with their HE counterparts (HR, 0.92 [95% CI, 0.77-1.11]; p = .40). Discussion Our findings suggest that baseline social participation is an important factor for the success of a PA intervention aimed at delaying mobility disability.
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Affiliation(s)
- Duane B Corbett
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | | | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Mary M McDermott
- Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Tufts University, Boston, Massachusetts
| | - Thomas M Gill
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut
| | - Abby C King
- Department of Health Research & Policy and Medicine, School of Medicine, Stanford University, California
| | - Michael E Miller
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Haiying Chen
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Marco Pahor
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville
| | - Todd M Manini
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville
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Matos FS, Jesus CSD, Carneiro JAO, Coqueiro RDS, Fernandes MH, Brito TA. Redução da capacidade funcional de idosos residentes em comunidade: estudo longitudinal. CIENCIA & SAUDE COLETIVA 2018; 23:3393-3401. [DOI: 10.1590/1413-812320182310.23382016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 10/12/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo deste estudo foi identificar a incidência e fatores de risco para a redução da capacidade funcional de idosos residentes em comunidade. Foi conduzido estudo de coorte prospectivo em duas fases, 2011 e 2014. A população do estudo foi composta por 202 idosos inicialmente independentes para as atividades básicas da vida diária. Utilizou-se como medida de associação o risco relativo (RR) e seus respectivos intervalos de confiança (IC) 95%, que foram estimados por regressão log-binomial com variância robusta. A incidência da redução de capacidade funcional foi de 15,3%. Os fatores de risco para o declínio funcional foram: estado civil sem união (RR aj = 2,75; IC95%: 1,15 – 6,57) e presença de sintomas de depressão (RR aj = 2,41; IC95%: 1,15 – 5,06), mesmo após ajuste por sexo, faixa etária, renda familiar per capita, diabetes, uso de medicamentos e nível de atividade física. A elevada incidência da redução de capacidade funcional e sua associação com aspectos da relação conjugal e de saúde mental revela a necessidade de considerar tais fatores no planejamento de ações em saúde voltadas à manutenção e recuperação da capacidade funcional dos idosos.
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Gao M, Sa Z, Li Y, Zhang W, Tian D, Zhang S, Gu L. Does social participation reduce the risk of functional disability among older adults in China? A survival analysis using the 2005-2011 waves of the CLHLS data. BMC Geriatr 2018; 18:224. [PMID: 30241507 PMCID: PMC6151053 DOI: 10.1186/s12877-018-0903-3] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 08/28/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Existing studies in developed countries show that social participation has beneficial effects on the functional ability of older adults, but research on Chinese older people is limited. This study examined the effects of participating in different types of social activities on the onset of functional disability and the underlying behavioral and psychosocial mechanisms among older adults aged 65 and older in China. METHODS The 2005, 2008, and 2011 waves of the Chinese Longitudinal Health Longevity Study were used. Life table analysis and discrete time hazard models were adopted to examine the relationship between social participation and functional disability. Social participation was defined as the frequencies of engaging in group leisure-time activities (i.e., playing cards/mahjong) and organized social activities, involving in informal social interactions (i.e., number of siblings frequently visited), and participating in paid jobs. Extensive social participation was measured by a composite index by adding up the four types of social activities that an older person was engaged in. RESULTS After controlling for the effect of socio-demographic characteristics, health status, and health behavioral factors, extensive social participation is associated with a significant reduced risk for the onset of functional disability (hazard ratio [HR] = 0.92, p < 0.001). Different types of social participation affect the risk of functional decline through different mechanisms. Frequent playing of cards/mahjong is a protective factor for functional decline (HR = 0.78, p < 0.001), and the relationship is partially mediated by cognitive ability and positive emotions (accounting for 18.9% and 7.0% of the association, respectively). Frequent participation in organized social activities is significantly related to a reduced risk of functional decline (HR = 0.78, p < 0.001), and the association is mediated by physical exercises and cognitive ability (accounting for 25.7% and 17.7% of the association, respectively). Frequent visits from siblings has a strong inverse relationship with functional decline (HR = 0.75, p < 0.001). However, no significant association between paid job and functional decline is observed. CONCLUSION Extensive social participation, regular engagement in group leisure-time activities, organized social activities, and informal social interactions in particular may have beneficial effects on the functional health of older adults through behavioral and psychosocial pathways. The findings shed light for the importance of promoting social participation among older adults.
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Affiliation(s)
- Min Gao
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, 100875 China
| | - Zhihong Sa
- School of Sociology, Beijing Normal University, No.19, Xinjiekou wai Street, Beijing, 100875 China
| | - Yanyu Li
- School of Humanities and Social Sciences, North China Electric Power University, Baoding, 071000 China
| | - Weijun Zhang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, 100875 China
| | - Donghua Tian
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, 100875 China
| | - Shengfa Zhang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, 100875 China
| | - Linni Gu
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, 100875 China
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Ali T, Nilsson CJ, Weuve J, Rajan KB, Mendes de Leon CF. Effects of social network diversity on mortality, cognition and physical function in the elderly: a longitudinal analysis of the Chicago Health and Aging Project (CHAP). J Epidemiol Community Health 2018; 72:990-996. [DOI: 10.1136/jech-2017-210236] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 04/27/2018] [Accepted: 06/13/2018] [Indexed: 11/03/2022]
Abstract
BackgroundHaving a larger social network has been shown to have beneficial effects on health and survival in adults, but few studies have evaluated the role of network diversity, in addition to network size. We explore whether social network diversity is associated with mortality, cognition and physical function among older black and white adults.MethodsData are obtained from the Chicago Health and Aging Project, a longitudinal, population-based study of adults aged 65 years and older at baseline. Using Cox proportional hazards regression, we estimate the hazard of mortality by network diversity (n=6497). The association between network diversity and cognition (n=6560) and physical function (n=6561) is determined using generalised estimating equations. Models were adjusted for age, gender, race, socioeconomic status, marital status and health-related variables.ResultsIn fully adjusted models, elderly with more diverse social networks had a lower risk of mortality (HR=0.93, p<0.01) compared with elderly with less diverse networks. Increased diversity in social networks was also associated with higher global cognitive function (coefficient=0.11, p<0.001) and higher physical function (coefficient=0.53, p<0.001).ConclusionsSocial networks are particularly important for older adults as they face the greatest threats to health and depend on network relationships, more than younger individuals, to meet their needs. Increasing diversity, and not just increasing size, of social networks may be essential for improving health and survival among older adults.
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Hao X, Gu J, Ying X, Bo T, Fu W. Social support and care needs of the disabled elderly population: An empirical study based on survey data from Beijing, China. Biosci Trends 2018; 11:507-515. [PMID: 29151554 DOI: 10.5582/bst.2017.01234] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In order to describe and examine differences in social support and care needs among disabled Chinese elderly, the current study used stratified sampling to survey local residents of Beijing age 60 or over in the districts of Xicheng, Chaoyang, and Tongzhou in 2016. Structured in-person interviews were conducted with a 7-domain questionnaire. Multiple logistic regressions were used to compare social support and care needs among functioning, partially disabled, and completely disabled elderly. All statistical analyses were performed using SPSS 19.0 with a significance level of 0.05 (two-sided). One thousand and eighty-three residents completed the survey. Based on Activities of Daily Living (ADL) scores, 736 (68.0%) respondents were functioning (ADL score = 14), 167 (15.4%) were partially disabled (14 < ADL score < 22), and 180 (16.6%) were fully disabled (ADL score ≥ 22). Most of the disabled had formal financial support, they received daily care at home, and they received modest emotional support. After controlling for confounding factors, fully disabled respondents were 2.35 times (p = 0.018) more likely to receive financial support and 3.65 times (p = 0.003) more likely to receive emotional support than functioning respondents. However, the fully functioning and partially disabled did not differ significantly in terms of financial or emotional support. Compared to fully functioning respondents, partially disabled respondents were 0.49 (p < 0.001) times less likely to be fully satisfied with their daily care while fully disabled respondents were 0.37 (p < 0.001) times less likely to be fully satisfied with that care. The current study provided a thorough depiction of the current status of social support and care needs of disabled Chinese elderly. More attention should be paid to social support for the partially disabled and daily care for both the partially and fully disabled.
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Affiliation(s)
- Xiaoning Hao
- China National Health Development Research Center, National Health and Family Planning Commission.,School of Public Health, Shandong University
| | - Juan Gu
- School of Public Administration, Chongqing University
| | - Xiangji Ying
- China National Health Development Research Center, National Health and Family Planning Commission
| | - Tao Bo
- College of Politics and Public Administration, Qingdao University
| | - Wei Fu
- China National Health Development Research Center, National Health and Family Planning Commission
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Bae S, Lee S, Lee S, Harada K, Makizako H, Park H, Shimada H. Combined effect of self-reported hearing problems and level of social activities on the risk of disability in Japanese older adults: A population-based longitudinal study. Maturitas 2018; 115:51-55. [PMID: 30049347 DOI: 10.1016/j.maturitas.2018.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/02/2018] [Accepted: 06/19/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND We used longitudinal cohort data to investigate whether hearing problems and low levels of social activity lead to a higher incidence of disability among community-dwelling older adults. METHODS Participants were 4576 older adults (47.8% male, mean age 75.9 years) who met the study inclusion criteria. Longitudinal data on the incidence of disability were monitored monthly. Disability was defined as Japanese long-term care insurance certification for personal support or care for 2 years following the baseline assessment. Hearing problems were measured using the Hearing Handicap Inventory for the Elderly and for Adults - Screening version. Participants completed a questionnaire that included five questions on daily social activities. RESULTS In the adjusted model that included potential covariates, participants with co-occurring hearing problems and low participation rates in social activities were at higher risk of developing a disability than participants without hearing problems and low levels of social activity (hazard ratio [HR] = 2.13, 95% confidence interval [CI]: 1.31-3.45). The second highest risk of developing a disability was found for those with low levels of social activity alone (HR = 1.98, 95% CI: 1.26-3.11), and the third highest for those with hearing problems alone (HR = 1.38, 95% CI: 1.07-1.77). CONCLUSIONS Hearing problems and a lack of social activity were independent risk factors for developing a disability. Co-occurring hearing problems and low levels of participation in social activities represented the largest risk factor for disability.
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Affiliation(s)
- Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan.
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Sungchul Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Kazuhiro Harada
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe 657-8501, Japan
| | - Hyuma Makizako
- School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hyuntae Park
- Department of Health Care Science, Dong-A University, 37, 550-Gil Nakdongdaero, Saha, Busan 604-714, Republic of Korea
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
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Jørgensen TSH, Lund R, Siersma VD, Nilsson CJ. Interplay between financial assets and social relations on decline in physical function and mortality among older people. Eur J Ageing 2018; 15:133-142. [PMID: 29867298 DOI: 10.1007/s10433-017-0437-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
It is well established that socioeconomic position (SEP) and social relations impact physical function and mortality in old age. Due to differential vulnerability, few social relations may lead to greater decline in physical function and mortality among older people with low compared to high SEP. The aim was to investigate whether older people with few social relations experience greater decline in physical function and mortality when also subject to low financial assets? The study population included 4060 older people aged 75 or 80 years at baseline in 1998-1999. Social relations at baseline and physical function at baseline and after 1.5, 3.0 and 4.5 years were obtained from questionnaires. Financial assets at baseline and mortality during 10 years of follow-up were obtained from registers. Analyses of the associations between financial assets combined with social relations and decline in physical function and mortality, respectively, were conducted. Among males, but not females, low financial assets and few social relations were associated with the greatest decline in physical function. Yet, interaction only reached significance between financial assets and visits. Among males and females, low financial assets and few social relations were associated with the highest mortality. Interactions only reached significance between financial assets and visits for females and social activity for males. In conclusion, few social relations implied greater decline in physical function among older males and higher mortality among older males and females with low financial assets; however, the study only supports the presence of differential vulnerability for visits and social activity.
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Affiliation(s)
- Terese Sara Høj Jørgensen
- 1Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014 Copenhagen, Denmark.,2Center for Healthy Aging, University of Copenhagen, 1123 Copenhagen, Denmark
| | - Rikke Lund
- 1Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014 Copenhagen, Denmark.,2Center for Healthy Aging, University of Copenhagen, 1123 Copenhagen, Denmark.,Danish Aging Research Center, University of Southern Denmark, University of Aarhus and University of Copenhagen, Copenhagen, Denmark
| | - Volkert Dirk Siersma
- 4The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 24, Entrance Q, Ground and 1st Floor, P.O. Box 2099, 1014 Copenhagen, Denmark
| | - Charlotte Juul Nilsson
- 1Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014 Copenhagen, Denmark.,2Center for Healthy Aging, University of Copenhagen, 1123 Copenhagen, Denmark
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Micheli K, Ratsika N, Vozikaki M, Chlouverakis G, Philalithis A. Family ties and functional limitation in the elderly: Results from the Survey of Health Ageing and Retirement in Europe (SHARE). Arch Gerontol Geriatr 2018; 78:23-29. [PMID: 29883806 DOI: 10.1016/j.archger.2018.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/17/2018] [Accepted: 05/31/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To examine if family ties are strong predictors of functional limitation in older adults in Europe. METHODS Cross sectional data were used and included 14 European countries from the second wave (w2) of the survey on Health, Ageing, and Retirement in Europe. 13,974 adults aged 50+ (45.2% males and 54.8%females) were included in the study. Functional limitation was assessed using activities of daily living (ADL), instrumental activities of daily living (i-ADL) and mobility sensory index. Family ties were based on a customized model of family structural aspects. Multiple logistic regression analyses were used to examine the risk of functional limitations. RESULTS Functional limitation was associated with females, age, self-rated health, and an increased number of chronic conditions, disease symptoms and depressive symptoms but not with few family ties. After controlling for potential confounders, respondents with lower family contacts showed higher risk for functional limitation. Southern and Mediterranean countries have both closer family ties and adults with higher functional limitation. CONCLUSION Functional limitation is associated with biological and demographic factors as well as little contact with family members. Further longitudinal research is required in order to determine the association and the causal relationship between functional limitation and family ties.
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Affiliation(s)
- Katerina Micheli
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece.
| | | | - Maria Vozikaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | | | - Anastas Philalithis
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
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When your world gets smaller: how older people try to meet their social needs, including the role of social technology. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000260] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACTSocial needs are important basic human needs. When social needs are not fulfilled, it can lead to mental and physical health problems. In an ageing society, meeting the social needs of older adults is important to sustain their wellbeing and quality of life. Social technology is used by younger people attempting to fulfil social needs. The aim of this study is to understand the social needs of older people and the role of social technology in fulfilling these needs. Using this information we will uncover opportunities for (technological) interventions. We conducted a qualitative explorative field study by interviewing 19 community-dwelling older adults. The participants were selected by professional care-givers with the help of a list of criteria for people at risk of social isolation or loneliness. Semi-structured interviews were held, using a topic list covering the following topics: social networks, social support, connectedness, neighbourhood, activities and hobbies, as well as use of and experiences with social technology. After thematic analysis, inductive codes were attached to quotations relevant to the research question. The results were described in four sections: (a) social needs and relationships; (b) the influence of life history and personality; (c) possibilities and barriers to meet social needs; and (d) use of and attitude towards social technology. The results indicate that the group of participants is heterogeneous and that their social needs and the way they try to meet these are diverse. The Social Production Functions Theory of Successful Aging (SPF-SA) was found to be a useful basis for interpreting and presenting the data. Social needs such as connectedness, autonomy, affection, behavioural confirmation and status are important for the wellbeing of older people. Although the need for affection is most easy to fulfil for older people, it looks like satisfaction of the need for behavioural confirmation and status are in some cases preferred, especially by the male participants. Resources such as relationships, activities, personal circumstances and social technology can help meet social needs. Where there is a lack of (physical) resources such as health problems, reduced mobility, death of network members, fear of rejection and gossip, and poor financial circumstances, meeting social needs can be more difficult for some older people. Social technology now plays a modest role in the lives of older people and in fulfilling their social needs. Because of its potential and its role in the lives of younger people, social technology can be seen as a promising resource in the satisfaction of social needs. However, since it is yet unknown how and to what extent the use of social network technologies, such as Facebook, can be beneficial for older people, more research in this area is needed. Based on our findings, we conclude that the world of older individuals is getting smaller. The loss of resources,e.g.the loss of one's health and mobility, may make it more difficult for an older person to connect with the world outside, which may result in a smaller social network. We therefore suggest that interventions to support older adults to meet their social needs may focus on two aspects: supporting and improving the world close by and bringing the world outside a little bit closer.
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